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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Stem Cells. Aug 26, 2021; 13(8): 1005-1029
Published online Aug 26, 2021. doi: 10.4252/wjsc.v13.i8.1005
Mesenchymal stem cells for enhancing biological healing after meniscal injuries
Hye Chang Rhim, Ok Hee Jeon, Seung-Beom Han, Ji Hoon Bae, Dong Won Suh, Ki-Mo Jang
Hye Chang Rhim, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States
Ok Hee Jeon, Department of Biomedical Sciences, Korea University College of Medicine, Seoul 02841, Seoul, South Korea
Seung-Beom Han, Ki-Mo Jang, Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, Seoul 02841, Seoul, South Korea
Ji Hoon Bae, Department of Orthopaedic Surgery, Guro Hospital, Korea University College of Medicine, Seoul 08308, Seoul, South Korea
Dong Won Suh, Department of Orthopaedic Surgery, Barunsesang Hospital, Seongnam 13497, South Korea
Author contributions: Jang KM and Rhim HC wrote the paper; Jeon OH, Han SB and Suh DW performed data collection and analysis; Jang KM, Jeon OH, Bae JH, and Han SB performed review and editing.
Supported by Technology Innovation Program (or Industrial Strategic Technology Development Program) funded by the Ministry of Trade, Industry & Energy (MOTIE, Korea), No. 20003688.
Conflict-of-interest statement: The authors declare no conflict of interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ki-Mo Jang, MD, PhD, Associate Professor, Doctor, Staff Physician, Surgeon, Department of Orthopaedic Surgery, Anam Hospital, Korea University College of Medicine, 73 Inchon-Ro, Seongbuk-gu, Seoul 02841, Seoul, South Korea. kimo98@hanmail.net
Received: February 28, 2021
Peer-review started: February 28, 2021
First decision: April 19, 2021
Revised: May 2, 2021
Accepted: July 15, 2021
Article in press: July 15, 2021
Published online: August 26, 2021
Processing time: 172 Days and 20.6 Hours
Abstract

The meniscus is a semilunar fibrocartilage structure that plays important roles in maintaining normal knee biomechanics and function. The roles of the meniscus, including load distribution, force transmission, shock absorption, joint stability, lubrication, and proprioception, have been well established. Injury to the meniscus can disrupt overall joint stability and cause various symptoms including pain, swelling, giving-way, and locking. Unless treated properly, it can lead to early degeneration of the knee joint. Because meniscal injuries remain a significant challenge due to its low intrinsic healing potential, most notably in avascular and aneural inner two-thirds of the area, more efficient repair methods are needed. Mesenchymal stem cells (MSCs) have been investigated for their therapeutic potential in vitro and in vivo. Thus far, the application of MSCs, including bone marrow-derived, synovium-derived, and adipose-derived MSCs, has shown promising results in preclinical studies in different animal models. These preclinical studies could be categorized into intra-articular injection and tissue-engineered construct application according to delivery method. Despite promising results in preclinical studies, there is still a lack of clinical evidence. This review describes the basic knowledge, current treatment, and recent studies regarding the application of MSCs in treating meniscal injuries. Future directions for MSC-based approaches to enhance meniscal healing are suggested.

Keywords: Meniscus; Meniscus healing; Cell-based treatment; Mesenchymal stem cell; Tissue engineering

Core Tip: The meniscus is important for maintaining normal knee joint function and should be preserved as much as possible to avoid rapid degeneration of the knee joint. Because the intrinsic meniscal healing potential is limited, an efficient repair method is necessary. Mesenchymal stem cells (MSCs) have shown promising results in recent preclinical and clinical studies. Further investigations for safe and efficient cell sources and scaffolds are necessary to validate safety and efficacy of MSC-based approaches for enhanced meniscal healing.